Hydroxychloroquine dose based upon weight and renal function

Discussion in 'Canadian Pharmacy' started by wgdiler, 22-Feb-2020.

  1. aptizzt Guest

    Hydroxychloroquine dose based upon weight and renal function


    Falciparum Discontinue in 6 months if improvement is inadequate Use in patients with psoriasis may precipitate a severe attack of psoriasis; use with caution Postmarketing cases of life-threatening and fatal cardiomyopathy reported with use of hydroxychloroquine as well as of chloroquine Irreversible retinal damage observed in some patients who had received hydroxychloroquine sulfate; significant risk factors for retinal damage include daily doses of hydroxychloroquine sulfate greater than 6.5 mg/kg (5 mg/kg base) of actual body weight, durations of use greater than five years, subnormal glomerular filtration, use of some concomitant drug products such as tamoxifen citrate and concurrent macular disease Ocular examination is recommended within first year of therapy; baseline exam should include: best corrected distance visual acuity (BCVA), an automated threshold visual field (VF) of the central 10 degrees (with retesting if an abnormality is noted), and spectral domain ocular coherence tomography (SD-OCT) For individuals with significant risk factors (daily dose of hydroxychloroquine sulfate 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease) monitoring should include annual examinations which include BCVA, VF and SD-OCT; for individuals without significant risk factors, annual exams can usually be deferred until five years of treatment In individuals of Asian descent, retinal toxicity may first be noticed outside macula; in patients of Asian descent, it is recommended that visual field testing be performed in central 24 degrees instead of central 10 degrees Hydroxychloroquine should be discontinued if ocular toxicity is suspected and patient should be closely observed given that retinal changes (and visual disturbances) may progress even after cessation of therapy Hepatic disease or alcoholism Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with hemolysis and renal impairment; use with caution Dermatologic reactions to hydroxychloroquine may occur Patients are prone to dermatitis outbreaks Signs or symptoms of cardiac compromise have appeared during acute and chronic treatment; clinical monitoring for signs and symptoms of cardiomyopathy is advised, including use of appropriate diagnostic tools such as ECG to monitor patients for cardiomyopathy during therapy; if cardiotoxicity is suspected, prompt discontinuation may prevent life-threatening complications Not for administration with other drugs that have potential to prolong QT interval; hydroxychloroquine prolongs QT interval; ventricular arrhythmias and torsades de pointes reported in patients taking hydroxychloroquine Skeletal muscle myopathy or neuropathy leading to progressive weakness and atrophy of proximal muscle groups, depressed tendon reflexes, and abnormal nerve conduction, reported; muscle and nerve biopsies have been associated with curvilinear bodies and muscle fiber atrophy with vacuolar changes; assess muscle strength and deep tendon reflexes periodically in patients on long-term therapy Suicidal behavior rarely reported in patients treated with hydroxychloroquine Hematologic reactions (including aplastic anemia) and agranulocytosis may occur May exacerbate heart failure Shown to cause severe hypoglycemia including loss of consciousness that could be life threatening in patients treated with or without antidiabetic medications; warn patients about risk of hypoglycemia and associated clinical signs and symptoms; patients presenting with clinical symptoms suggestive of hypoglycemia during treatment should have their blood glucose checked and treatment reviewed as necessary A reduction in dosage may be necessary in patients with hepatic or renal disease, as well as in those taking medicines known to affect these organs Use with caution in patients with hepatic disease or alcoholism or in conjunction with known hepatotoxic drugs Consider discontinuing therapy if any severe blood disorder such as aplastic anemia, agranulocytosis, leukopenia, or thrombocytopenia, which is not attributable to the disease under treatment appears; perform periodic blood cell counts if patients are given prolonged therapy Pregnancy category: C Lactation: Drug is concentrated in breast milk (American Academy of Pediatrics committee states that it is compatible with nursing) A: Generally acceptable. Contact the applicable plan provider for the most current information. Controlled studies in pregnant women show no evidence of fetal risk. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. Animal studies show risk and human studies not available or neither animal nor human studies done.

    Vision changes to watch for on plaquenil Sigma chloroquine diphosphatase

    Note The risk of retinopathy is reduced when the daily maintenance dose is less than 6.5 mg 5 mg base per kg of body weight mg/kg and the cumulative dose is less than 200 grams, the duration of treatment is less than 10 years, and renal function is not impaired {69} {70}. Incidence rare Aplastic anemia fatigue; weakness Mar 14, 2016 Regarding the dosing of hydroxychloroquine, we advocate the use of a weight based dosing regimen with a cap at 400 mg per day, except in the case of renal insufficiency, when the dose should be reduced to 200 mg per day and for those on dialysis, who should take their hydroxychloroquine, 200 mg three times per week. Dosages of drugs cleared renally are based on renal function calculated as GFR or creati-nine clearance; Table 3. These calculations are valid only when renal function is stable

    Unknown; may impair complement-dependent antigen-antibody reactions; inhibits locomotion of neutrophils and chemotaxis of eosinophils Increases p H and interferes with lysosomal degradation of hemoglobin, which in turn interferes with digestive vacuole function Bioavailability: Rapid and complete absorption Onset: May take 4-6 months to show response; peak response takes several months (rheumatic disease) Duration: Unknown Peak plasma time: 1-3 hr Protein bound: 55% Metabolites: Desethylhydroxychloroquine, desethylchloroquine Half-life: 32-50 days Excretion: Urine (60%) The above information is provided for general informational and educational purposes only. D: Use in LIFE-THREATENING emergencies when no safer drug available.

    Hydroxychloroquine dose based upon weight and renal function

    RheumNow Hydroxychloroquine Blood Levels in SLE MedPage Today, The Role of Hydroxychloroquine Blood Levels in SLE RheumNow.

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  3. Hydroxychloroquine sulfate 200 mg brand name
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  5. Nov 01, 2017 Weight based dosage in adults and pediatric patients 13 mg/kg 10 mg/kg base, not to exceed 800 mg 620 mg base followed by 6.5 mg/kg 5 mg/kg base, not to exceed 400 mg 310 mg base, at 6 hours, 24 hours and 48 hours after the initial dose. Hydroxychloroquine sulfate film-coated tablets cannot be divided, therefore they should not be used.

    • DailyMed - HYDROXYCHLOROQUINE SULFATE tablet, film coated.
    • Drug Dosing Adjustments in Patients with Chronic Kidney Disease.
    • Immunosuppressive effects of hydroxychloroquine and..

    All patients in the cohort were prescribed hydroxychloroquine not to exceed a dose of 6.5 mg per kilogram. The maximum daily dose prescribed is 400 mg. In those who are on hemodialysis 200 mg was prescribed after each dialysis session. In those with renal insufficiency, the dose was 200mg daily. Regarding the dosing of hydroxychloroquine, we advocate the use of a weight-based dosing regimen with a cap at 400 mg per day, except in the case of renal insufficiency, when the dose should be reduced to 200 mg per day and for those on dialysis, who should take their hydroxychloroquine at 200 mg three times per week. Abstract. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. Pattern of Retinopathy Although the locus of toxic damage is parafoveal in many eyes, Asian.

     
  6. RUSty XenForo Moderator

    The NICE Clinical Knowledge Summaries (CKS) site is only available to users in the UK, Crown Dependencies and British Overseas Territories. Wearable Health Devices—Vital Sign Monitoring, Systems and. Hydroxychloroquine-Induced Retinal Toxicity - American. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION
     
  7. Akiro Well-Known Member

    Hydroxychloroquine is used to prevent or treat malaria infections caused by mosquito bites. Hydroxychloroquine 'Probably Safe' in Pregnancy MDedge ObGyn Precautions and Warnings With Hydroxychloroquine Trends in Use of Hydroxychloroquine during Pregnancy in SLE.
     
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